Article(id=1324044853646078257, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202511360, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1763740800000, receivedDateStr=2025-11-22, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793606492673, onlineDateStr=2026-11-02, pubDate=1779638400000, pubDateStr=2026-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793606492673, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793606492673, creator=13701087609, updateTime=1793606492673, updator=13701087609, issue=Issue{id=1324044701648695723, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='10', pageStart='1729', pageEnd='1920', issueExtLink='null', onlineDate='null', pubDate='1779638400000', pubDateStr='2026-05-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793606456434, creator='13701087609', updateTime=1793670074552, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311535425815306, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311535425815307, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324044701648695723, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1880, endPage=1885, ext={EN=ArticleExt(id=1324044853914513714, articleId=1324044853646078257, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Study on the relationship between nighttime sleep duration and falls in elderly individuals with chronic diseases, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the dose-response relationship between nighttime sleep duration and fall risk among older adults with chronic diseases, and to analyze age differences, thereby informing targeted interventions.

Methods

A questionnaire survey was conducted from January to May 2024 among adults aged ≥60 years in Shandong Province. Logistic regression was used to assess fall risk across different sleep durations. Restricted cubic splines (RCS) were applied to analyze nonlinear associations, with age-stratified analysis performed.

Results

Among 1 421 older adults with chronic diseases, the fall incidence was 18.7%. RCS analysis revealed a significant nonlinear relationship between nighttime sleep duration and fall risk (overall trend P<0.001, nonlinear P=0.019). The optimal overall sleep duration was 7-8 h. Age-stratified results showed that among individuals aged 60-70 years, those sleeping 6-7 h had the lowest fall risk (overall trend P<0.001, nonlinear P=0.011). while those aged 71-80 had the lowest fall risk with 7-8 h of sleep (overall trend P=0.003, nonlinear P=0.037). For individuals aged 81 and older, the relationship between sleep duration and fall risk was not significantly nonlinear (overall trend P=0.182, nonlinear P=0.109).

Conclusion

Nighttime sleep duration and fall risk exhibit a U-shaped curve in older adults with chronic diseases, with optimal duration varying by age. Appropriately managing sleep duration may help reduce fall risk.

, authors=Jing-wen CHANG1, Guang-ning CHEN1, Jia-qi ZHANG1, Qian-qian GAO1, 3, Qi JING1, 3, Run-guo GAO2, 3, Hong-qing AN2, 3, Wei-qin CAI1, 3, authorsList=Jing-wen CHANG, Guang-ning CHEN, Jia-qi ZHANG, Qian-qian GAO, Qi JING, Run-guo GAO, Hong-qing AN, Wei-qin CAI, authorCompany=null, correspAuthors=Wei-qin CAI, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324044856737280316, articleId=1324044853646078257, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=慢性病老年人夜间睡眠时长与跌倒的关系研究, columnId=1228016572640461823, journalTitle=现代预防医学, columnName=健康与社会行为, runingTitle=null, highlight=null, articleAbstract=
目的

探讨慢性病老年人夜间睡眠时长与跌倒风险之间的剂量-反应关系及年龄差异,为精准干预提供依据。

方法

于2024年1月—5月在山东省对60岁以上老年人开展问卷调查。通过logistic分析慢性病老年人夜间睡眠时长与跌倒的差异。采用限制性立方样条(RCS)分析夜间睡眠时长与跌倒风险的关系,并进行年龄分层分析。

结果

共纳入1 421名慢性病老年人,跌倒率18.7%。RCS分析显示夜间睡眠时长与跌倒风险呈显著非线性关系(总趋势P<0.001,非线性P=0.019)。总体最佳睡眠时长为7~8 h。年龄分层显示,60~70岁的老年人的最佳睡眠时长为6~7 h(总趋势P<0.001,非线性P=0.011),71~80岁老年人最佳睡眠时长7~8 h(总趋势P=0.003,非线性P=0.037),≥81岁非线性关系不显著(总趋势P=0.182,非线性P=0.109)。

结论

慢性病老年人夜间睡眠时长与跌倒风险呈“U”型曲线关系,不同年龄段老年人的睡眠时长呈现显著非线性关系,最佳睡眠时长存在年龄差异。建议合理干预睡眠时长以降低跌倒的发生风险。

, authors=常竞文1, 陈光宁1, 张嘉琪1, 高倩倩1, 3, 井淇1, 3, 高润国2, 3, 安洪庆2, 3, 蔡伟芹1, 3, authorsList=常竞文, 陈光宁, 张嘉琪, 高倩倩, 井淇, 高润国, 安洪庆, 蔡伟芹, authorCompany=null, correspAuthors=蔡伟芹, authorNote=

常竞文(2001—),女,硕士在读,研究方向:卫生健康政策与管理

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蔡伟芹,E-mail:
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Research on the association between sleep duration and falls in middle-aged and elderly populations in China[J]. Modern Preventive Medicine, 2025, 52(7): 1300-1305. (In Chinese), articleTitle=Research on the association between sleep duration and falls in middle-aged and elderly populations in China, refAbstract=null), Reference(id=1324045140603569065, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044853646078257, doi=null, pmid=null, pmcid=null, year=2025, volume=16, issue=1, pageStart=197, pageEnd=204, url=null, language=null, rfNumber=[24], rfOrder=41, authorNames=Salis F, Lecca R, Belfiori M, journalName=European Geriatric Medicine, refType=null, unstructuredReference=Salis F, Lecca R, Belfiori M, et al. Sleep quality, daytime sleepiness, and risk of falling:results from an exploratory cross-sectional study[J]. 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Fall incidence among older adults with different characteristics

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变量N(%)/M(P25,P75)跌倒情况统计值
(χ2/Z)
P值
不跌倒(%)跌倒(%)
夜间睡眠时长(h)23.208<0.001
<6198(13.9)139(70.2)59(29.8)
6~<7293(20.6)236(80.5)57(19.5)
7~<8461(32.4)397(86.1)64(13.8)
≥8469(33.0)383(81.7)86(18.3)
性别12.065<0.001
男616(56.7)526(85.4)90(14.6)
女805(43.3)629(78.1)176(21.9)
年龄(岁)45.283<0.001
60~70669(47.1)586(87.6)83(12.4)
71~80635(44.7)494(77.8)141(22.2)
≥81117(8.2)75(64.1)42(35.9)
婚姻状况4.4000.221
未婚9(0.6)8(88.9)1(11.1)
已婚1 163(81.8)955(82.1)208(17.9)
离异24(1.7)20(83.3)4(16.7)
丧偶225(15.8)172(76.4)53(23.6)
居住地类型31.054<0.001
城市721(50.7)627(87.0)94(13.0)
农村700(49.3)528(75.4)172(24.6)
BMI6.1350.105
体重过轻28(2.0)20(71.4)8(28.6)
体重正常589(41.4)486(82.5)103(17.5)
超重607(42.7)499(82.2)108(17.8)
肥胖197(13.9)150(76.1)47(23.9)
是否独居0.6180.432
否1 259(88.6)1 027(81.6)232(18.4)
是162(11.4)128(79.0)34(21.0)
是否锻炼27.914<0.001
否706(49.7)535(75.8)171(24.2)
是715(50.3)620(86.7)95(13.3)
慢性病共病9.7700.002
否847(59.6)711(83.9)136(16.1)
是574(40.4)444(77.4)130(22.6)
平衡能力52(44.5,56)53(47,56)45(36,52)-10.398<0.001
), ArticleFig(id=1324045134098203511, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044853646078257, language=CN, label=表1, caption=

不同特征慢性病老年人的跌倒发生情况

, figureFileSmall=null, figureFileBig=null, tableContent=
变量N(%)/M(P25,P75)跌倒情况统计值
(χ2/Z)
P值
不跌倒(%)跌倒(%)
夜间睡眠时长(h)23.208<0.001
<6198(13.9)139(70.2)59(29.8)
6~<7293(20.6)236(80.5)57(19.5)
7~<8461(32.4)397(86.1)64(13.8)
≥8469(33.0)383(81.7)86(18.3)
性别12.065<0.001
男616(56.7)526(85.4)90(14.6)
女805(43.3)629(78.1)176(21.9)
年龄(岁)45.283<0.001
60~70669(47.1)586(87.6)83(12.4)
71~80635(44.7)494(77.8)141(22.2)
≥81117(8.2)75(64.1)42(35.9)
婚姻状况4.4000.221
未婚9(0.6)8(88.9)1(11.1)
已婚1 163(81.8)955(82.1)208(17.9)
离异24(1.7)20(83.3)4(16.7)
丧偶225(15.8)172(76.4)53(23.6)
居住地类型31.054<0.001
城市721(50.7)627(87.0)94(13.0)
农村700(49.3)528(75.4)172(24.6)
BMI6.1350.105
体重过轻28(2.0)20(71.4)8(28.6)
体重正常589(41.4)486(82.5)103(17.5)
超重607(42.7)499(82.2)108(17.8)
肥胖197(13.9)150(76.1)47(23.9)
是否独居0.6180.432
否1 259(88.6)1 027(81.6)232(18.4)
是162(11.4)128(79.0)34(21.0)
是否锻炼27.914<0.001
否706(49.7)535(75.8)171(24.2)
是715(50.3)620(86.7)95(13.3)
慢性病共病9.7700.002
否847(59.6)711(83.9)136(16.1)
是574(40.4)444(77.4)130(22.6)
平衡能力52(44.5,56)53(47,56)45(36,52)-10.398<0.001
), ArticleFig(id=1324045134232421240, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044853646078257, language=EN, label=Table 2, caption=

Logistic regression analysis of nighttime sleep duration and fall incidence

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项目夜间睡眠时长(h)回归系数标准误OR值(95%CI)P值
单因素<6
6~<7-0.5640.2140.569(0.374~0.866)0.009
7~<8-0.9680.2060.380(0.254~0.568)<0.001
≥8-0.6370.1960.529(0.360~0.777)0.001
模型1<6
6~<7-0.4990.2180.607(0.396~0.931)0.022
7~<8-0.9330.2100.393(0.261~0.594)<0.001
≥8-0.6540.2000.520(0.352~0.770)0.001
模型2<6
6~<7-0.2790.2340.756(0.478~1.197)0.233
7~<8-0.9440.2260.389(0.250~0.606)<0.001
≥8-0.6310.2150.532(0.349~0.810)0.003
), ArticleFig(id=1324045134316307321, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324044853646078257, language=CN, label=表2, caption=

夜间睡眠时长与跌倒情况的logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目夜间睡眠时长(h)回归系数标准误OR值(95%CI)P值
单因素<6
6~<7-0.5640.2140.569(0.374~0.866)0.009
7~<8-0.9680.2060.380(0.254~0.568)<0.001
≥8-0.6370.1960.529(0.360~0.777)0.001
模型1<6
6~<7-0.4990.2180.607(0.396~0.931)0.022
7~<8-0.9330.2100.393(0.261~0.594)<0.001
≥8-0.6540.2000.520(0.352~0.770)0.001
模型2<6
6~<7-0.2790.2340.756(0.478~1.197)0.233
7~<8-0.9440.2260.389(0.250~0.606)<0.001
≥8-0.6310.2150.532(0.349~0.810)0.003
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慢性病老年人夜间睡眠时长与跌倒的关系研究
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常竞文 1 , 陈光宁 1 , 张嘉琪 1 , 高倩倩 1, 3 , 井淇 1, 3 , 高润国 2, 3 , 安洪庆 2, 3 , 蔡伟芹 1, 3
现代预防医学 | 健康与社会行为 2026,53(10): 1880-1885
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现代预防医学 |健康与社会行为 2026 , 53 (10) : 1880 -1885
慢性病老年人夜间睡眠时长与跌倒的关系研究
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常竞文1, 陈光宁1, 张嘉琪1, 高倩倩1, 3, 井淇1, 3, 高润国2, 3, 安洪庆2, 3, 蔡伟芹1, 3
作者信息
  • 1.山东第二医科大学管理学院,山东 潍坊 261053
  • 2.山东第二医科大学公共卫生学院
  • 3.山东第二医科大学公共卫生危机研究所
通讯作者:
蔡伟芹,E-mail:
作者简介:

常竞文(2001—),女,硕士在读,研究方向:卫生健康政策与管理

Study on the relationship between nighttime sleep duration and falls in elderly individuals with chronic diseases
Jing-wen CHANG1, Guang-ning CHEN1, Jia-qi ZHANG1, Qian-qian GAO1, 3, Qi JING1, 3, Run-guo GAO2, 3, Hong-qing AN2, 3, Wei-qin CAI1, 3
Affiliations
  • School of Management, Shandong Second Medical University, Weifang, Shandong 261053, China
出版时间: 2026-05-25 doi: 10.20043/j.cnki.MPM.202511360
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目的

探讨慢性病老年人夜间睡眠时长与跌倒风险之间的剂量-反应关系及年龄差异,为精准干预提供依据。

方法

于2024年1月—5月在山东省对60岁以上老年人开展问卷调查。通过logistic分析慢性病老年人夜间睡眠时长与跌倒的差异。采用限制性立方样条(RCS)分析夜间睡眠时长与跌倒风险的关系,并进行年龄分层分析。

结果

共纳入1 421名慢性病老年人,跌倒率18.7%。RCS分析显示夜间睡眠时长与跌倒风险呈显著非线性关系(总趋势P<0.001,非线性P=0.019)。总体最佳睡眠时长为7~8 h。年龄分层显示,60~70岁的老年人的最佳睡眠时长为6~7 h(总趋势P<0.001,非线性P=0.011),71~80岁老年人最佳睡眠时长7~8 h(总趋势P=0.003,非线性P=0.037),≥81岁非线性关系不显著(总趋势P=0.182,非线性P=0.109)。

结论

慢性病老年人夜间睡眠时长与跌倒风险呈“U”型曲线关系,不同年龄段老年人的睡眠时长呈现显著非线性关系,最佳睡眠时长存在年龄差异。建议合理干预睡眠时长以降低跌倒的发生风险。

慢性病  /  老年人  /  跌倒  /  睡眠时长  /  剂量-反应分析
Objective

To investigate the dose-response relationship between nighttime sleep duration and fall risk among older adults with chronic diseases, and to analyze age differences, thereby informing targeted interventions.

Methods

A questionnaire survey was conducted from January to May 2024 among adults aged ≥60 years in Shandong Province. Logistic regression was used to assess fall risk across different sleep durations. Restricted cubic splines (RCS) were applied to analyze nonlinear associations, with age-stratified analysis performed.

Results

Among 1 421 older adults with chronic diseases, the fall incidence was 18.7%. RCS analysis revealed a significant nonlinear relationship between nighttime sleep duration and fall risk (overall trend P<0.001, nonlinear P=0.019). The optimal overall sleep duration was 7-8 h. Age-stratified results showed that among individuals aged 60-70 years, those sleeping 6-7 h had the lowest fall risk (overall trend P<0.001, nonlinear P=0.011). while those aged 71-80 had the lowest fall risk with 7-8 h of sleep (overall trend P=0.003, nonlinear P=0.037). For individuals aged 81 and older, the relationship between sleep duration and fall risk was not significantly nonlinear (overall trend P=0.182, nonlinear P=0.109).

Conclusion

Nighttime sleep duration and fall risk exhibit a U-shaped curve in older adults with chronic diseases, with optimal duration varying by age. Appropriately managing sleep duration may help reduce fall risk.

Chronic diseases  /  Elderly individuals  /  Falls  /  Sleep duration  /  Dose-response analysis
常竞文, 陈光宁, 张嘉琪, 高倩倩, 井淇, 高润国, 安洪庆, 蔡伟芹. 慢性病老年人夜间睡眠时长与跌倒的关系研究. 现代预防医学, 2026 , 53 (10) : 1880 -1885 . DOI: 10.20043/j.cnki.MPM.202511360
Jing-wen CHANG, Guang-ning CHEN, Jia-qi ZHANG, Qian-qian GAO, Qi JING, Run-guo GAO, Hong-qing AN, Wei-qin CAI. Study on the relationship between nighttime sleep duration and falls in elderly individuals with chronic diseases[J]. Modern Preventive Medicine, 2026 , 53 (10) : 1880 -1885 . DOI: 10.20043/j.cnki.MPM.202511360
随着全球人口老龄化,老年人跌倒成为重要公共卫生问题。全球每年约有68.4万人因跌倒死亡,其中60岁以上老年人占比超过一半[1]。我国老年人跌倒率达19.3%[2]。跌倒造成骨折、恐惧等身心方面的不良健康后果[3],还导致了高额的医疗负担[4]。老年人是慢性病的高发群体,我国慢性病死亡人数占总死亡人数的比例超过80%[5]。慢性病不仅引起躯体功能障碍,降低老年人的生命质量,并且造成巨大的经济负担[6]。慢性病所致的生理功能受损进一步增加了老年人跌倒的风险[7]。慢性病老年人由于自身基础疾病影响,发生跌倒后损伤愈合难度大,且更易诱发基础疾病急性发作[8]。因此要重视慢性病老年人跌倒的干预防治。
睡眠时长是一个可调控的跌倒影响因素。既往研究利用分组比较证实了睡眠时长与老年人跌倒风险之间存在的关联,即睡眠过短(<5 h)或过长(>8 h)均与跌倒风险增加相关[9],然而,此类研究将睡眠时长作为分类变量进行处理,难以揭示睡眠时长在连续变化上与跌倒之间的剂量-反应关系。慢性病老年人更容易出现睡眠问题[10]。既往研究多将睡眠时长作为分类变量进行分析,缺乏从连续尺度上揭示其与跌倒风险之间的精确剂量-反应关系,对于慢性病老年人,尚缺乏基于连续数据模型的精细证据,未能充分解释其与跌倒风险的非线性关系。因此,本研究基于限制性立方样条(RCS)来探讨慢性病老年人的夜间睡眠时长与跌倒风险的剂量-反应关系,并分析不同年龄段的差异,旨在揭示睡眠时长与跌倒的关联,为慢性病老年人制定更加精准的干预策略提供依据。
于2024年1月至5月在山东省采用分层随机抽样方法,选取10个地级市,每个市抽取2个县(区),每个县(区)随机选取1个城市社区和1个农村社区作为样本点。对样本点内60岁及以上老年人进行问卷调查。本研究纳入标准:(1)年龄≥60岁;(2)患有被医学诊断的慢性病;(3)本人或家属知情同意,并签署同意书。排除认知障碍、拒绝回答或关键变量缺失者。此次调查共收集2 300份问卷,其中慢性病老年人1 433人,经过排除和纳入标准后,本研究最终纳入1 421例样本。本研究已获得山东第二医科大学医学伦理委员会的审核通过(批准号:2021YX092),且所有受试者均在调查前签署了知情同意书。
本研究老年人的跌倒是通过询问调查对象“过去一年您跌倒过吗?”这一问题来衡量,由调查对象回答“是”或“否”。若调查对象回答“是”,则进一步询问发生跌倒的次数。
本研究通过询问调查对象“近一个月来,您每晚通常睡眠几个小时(不等于卧床时间)?”来确定老年人的夜间睡眠时长。本研究根据四分位数将睡眠时间划分为4组:<6 h组、6~<7 h组、7~<8 h组、≥8 h组。
本研究选择性别、年龄、居住地类型、是否锻炼、是否慢性病共病以及平衡能力作为协变量。其中,性别(男/女)、年龄(60~70岁/71~80岁/≥81岁)、居住地类型(城市/农村)、是否锻炼(是/否)、慢性病共病是指患有两种及以上慢性病(是/否)作为分类变量,平衡能力通过Berg平衡量表进行衡量,得分范围为0~64分,得分越高,平衡能力越高[11],在本研究中作为连续变量。
采用Epidata 3.1进行数据录入。使用SPSS 27.0对数据进行描述统计分析,经检验本研究的连续变量(平衡能力)为非正态分布。计数资料用N(%)描述,计量资料用中位数(M)和四分位数(P25,P75)表示。通过卡方检验(分类变量)和Mann-Whitney U检验(连续变量)对跌倒情况组间进行比较。通过logistic回归分析确定慢性病老年人睡眠时长与跌倒之间的关系。使用R 4.5.1软件,将睡眠时长作为连续变量,通过赤池信息量准则(AIC值)选择最佳节点数,采用RCS模型分析慢性病老年人睡眠时长与跌倒的剂量-反应关系。分别对“60~70岁”、“71~80岁”和“≥81岁”年龄组进行年龄分层分析。检验水准α=0.05。
在1 421名慢性病老年人中,在过去一年发生过跌倒的共有266人,跌倒率为18.7%。其中,60~70岁、71~80岁、≥81岁老年人的跌倒率分别为12.4%、22.2%和35.9%。夜间睡眠时长在<6 h组、6~<7 h组、7~<8 h组、≥8 h组的跌倒率分别为29.8%、19.5%、13.8%、18.3%。单因素分析显示,性别、年龄、居住地类型、是否锻炼、慢性病共病、平衡能力、睡眠时长对慢性病老年人的跌倒差异具有统计学意义(P<0.05)。见表1。
以睡眠时长<6 h为参照,在未调整模型中,6~<7 h、7~<8 h和≥8 h组的跌倒风险均降低(P<0.05)。调整年龄后(模型1),保护效应仍然显著。进一步调整性别、居住地类型、是否锻炼、是否慢性病共病、平衡能力等因素后(模型2),7~<8 h和≥8 h组的保护作用依然显著(P<0.05),6~<7 h组差异无统计学意义(P=0.233)。见表2。
通过比较4~7个节点的AIC值,确定4节点模型拟合最优(AIC=1 204.87)。因此,后续RCS分析采用4个节点。调整混杂变量后,夜间睡眠时长与跌倒风险呈现显著的非线性关系(总趋势P<0.001,非线性P=0.019)。当睡眠时间少于4.5 h时,睡眠时长越短,跌倒风险越高。风险最低点位于7~8 h,超过8 h后,睡眠时长的保护作用逐渐降低,跌倒风险缓慢上升。如图1所示。
年龄分层分析显示,60~70岁组的睡眠时间与跌倒风险存在显著非线性关系(总趋势P<0.001,非线性P=0.011)。睡眠时长短于5 h时风险随睡眠减少而上升,最佳睡眠时长为6~7 h,超过7 h后风险缓慢上升并趋于平稳,见图2。71~80岁组同样观察到睡眠时间与跌倒风险的显著关联(总趋势P=0.003,非线性P=0.037)。最佳睡眠时长7~8 h,以此值为参考,睡眠时长过短或过长均会导致跌倒风险的增加,见图3。≥81岁组中,非线性关系不显著(总趋势P=0.182,非线性P=0.109),见图4。
本研究分析了山东省60岁及以上慢性病老年人的夜间睡眠时长与跌倒风险的关系。本研究中,慢性病老年人的跌倒率为18.7%。60~70岁、71~80岁以及≥81岁各年龄段的跌倒率分别为12.4%、22.2%和35.9%,与已有结果相似[12],显示出跌倒风险随着年龄增长而增加的趋势。另外,由于慢性病的影响,如糖尿病引发的周围神经病变使足部感觉减退,高血压患者服用降压药物后可能导致对跌倒的警觉度下降[13]或引发晕厥或体位性低血压等[14-15],进一步增加了跌倒风险。
Logistic回归结果显示,以<6 h为参考组,7~<8 h和≥8 h的跌倒风险分别降低61.1%、46.8%;6~<7 h的影响不显著。这表明睡眠过短更易增加跌倒风险。过短的睡眠时间会导致平衡力下降[16]、抑郁和注意力下降[17],这些都被视为老年人跌倒风险因素。睡眠时长≥8 h的保护作用较7~<8 h略有降低,提示过长睡眠会增加跌倒风险,睡眠过长会造成老年人认知能力下降[19]、肌肉萎缩[20]等因素,进而增加跌倒风险[21-22]。
RCS结果分析显示,慢性病老年人夜间睡眠时长与跌倒风险呈非线性关系,与以往研究结果一致[23]。整体最佳睡眠时长为7~8 h,当睡眠时间小于4.5 h时,跌倒风险随着睡眠时长变短而增加;当睡眠时长超过8 h后,跌倒风险则随睡眠增加而缓慢增加。年龄分层显示,60~70岁、71~80岁组的睡眠时长与跌倒风险的关联均呈现显著的非线性关系,≥81岁组的睡眠时长与跌倒风险的非线性关系不显著。不同年龄段的最佳睡眠时长存在差异:60~70岁组6~7 h,71~80岁组为7~8 h。这可能与年龄增长的生理机能衰退及慢性病进展有关,与60~70岁的老年人相比,71~80岁的老年人可能因生理功能进一步衰退,需要更多的睡眠时间来维持身体机能[24]。≥80岁的慢性病老年人睡眠时长与跌倒风险的非线性关系不显著,这一结果可能主要归因于该亚组样本量相对有限(n=117),导致统计检验效力欠佳。
为此,临床医生在管理慢性病时,应主动询问老年人睡眠状况,对偏离最佳睡眠时长的患者,应进行多维评估,排查药物副作用、未控制的疼痛等可调因素;社区卫生人员可通过开展睡眠卫生教育指导其有效睡眠时长至7~8 h。运动干预对老年失眠患者的睡眠具有显著效果[25]。因此,建议按照年龄分段通过精准的睡眠指导和运动干预来优化慢性病老年人的睡眠时长,降低跌倒风险。
本研究存在一定局限性。首先,跌倒经历与睡眠时长是由老年人自我回忆采集的,虽已通过标准化问卷和培训调查员尽量降低误差,仍不可避免地存在回忆偏倚。其次,本研究未细分慢性病类型,未来研究可进一步探讨不同类型慢性病老年人的睡眠时长与跌倒的关系。另外,本研究仅纳入了部分混杂因素的影响,未全面纳入其他混杂因素,未来研究需要全面收集协变量以减少混杂偏倚。
  • 国家自然科学基金项目(72104186)
  • 山东省自然科学基金项目(ZR2021MG019)
  • 山东省人文社会科学智库重点专项(2023-zkzd-078)
  • 中国高等教育学会高等教育科学研究规划课题(24BJ0401)
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2026年第53卷第10期
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doi: 10.20043/j.cnki.MPM.202511360
  • 接收时间:2025-11-22
  • 首发时间:2026-11-02
  • 出版时间:2026-05-25
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  • 收稿日期:2025-11-22
基金
国家自然科学基金项目(72104186)
山东省自然科学基金项目(ZR2021MG019)
山东省人文社会科学智库重点专项(2023-zkzd-078)
中国高等教育学会高等教育科学研究规划课题(24BJ0401)
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    1.山东第二医科大学管理学院,山东 潍坊 261053
    2.山东第二医科大学公共卫生学院
    3.山东第二医科大学公共卫生危机研究所

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
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